Navigation Links
AHIP Releases Individual Market Guarantee Access Proposal, Announces Support for Third Party Review of Rescission Decisions
Date:12/19/2007

Ignagni: "This initiative is a fundamental repositioning."

WASHINGTON, Dec. 19 /PRNewswire-USNewswire/ -- One year ago America's Health Insurance Plans' (AHIP) Board of Directors advanced a proposal to provide universal coverage. Today, the Board released a proposal to guarantee access to health care coverage in the individual market and announced support for third party review of rescission decisions and their commitment to limiting pre-existing condition exclusions.

(Logo: http://www.newscom.com/cgi-bin/prnh/20040830/AHIPLOGO )

"We are committed to working with legislators and other stakeholders to identify policy solutions to the health care challenges facing our nation," said George Halvorson, Chairman and CEO of Kaiser Permanente and Chairman of AHIP's Board of Directors.

The individual health insurance market continues to be the center of various reform proposals to expand access to health care coverage. Continuing on its mission to improve the accessibility, affordability, and quality of health care in America, in June the AHIP Board established an Individual Market Task Force to examine this issue and put forth both policy and operational recommendations.

The result is a three-part proposal that includes a plan to guarantee access to health care coverage to all Americans, new initiatives to give consumers peace of mind about individual health care coverage, and steps states need to take if they are considering a requirement for universal participation.

"Health plans from across the country came together to address the unique challenges facing the individual health insurance market. We believe that plans and the states, working together, can guarantee access to affordable insurance for everyone in the individual market," said Jay Gellert, President and CEO of Health Net, Inc. and Co-Chairman of the Individual Market Task Force.

"This initiative is a fundamental repositioning," said Karen Ignagni, President and CEO of AHIP. "Our Board is committed to ensuring that no American falls between the cracks of public and private programs and that individuals can have their disputes reviewed by an objective third party."

First, the AHIP Board is proposing a strategy that states can implement now to guarantee access to health insurance to all who seek coverage in the individual market, including those with pre-existing medical conditions.

Under this plan, states should establish Guarantee Access Plans to provide coverage for uninsured individuals with the highest expected medical costs. If an individual is not eligible for coverage through the Guarantee Access Plan, health plans would then provide coverage to that individual on a guarantee issue basis with premiums capped at one-and-one-half times the standard rate.

"Health insurance plans believe that everyone should have access to affordable health care coverage regardless of their health status or income," said Don Hamm, President and CEO of Assurant Health and Chair of the Access Subcommittee. "We look forward to working with states to achieve this goal immediately."

Second, the proposal includes a series of operational reforms to give consumers peace of mind when purchasing individual health care coverage. These include limiting the use of pre-existing conditions exclusions, restricting rescission actions, and establishing a new third-party review process for pre-existing conditions and rescission decisions.

Specifically, the Board is recommending that health plans waive the application of pre-existing condition exclusions for medical conditions that are disclosed and should limit rescission actions to those based on information that should have been included in a complete and accurate response to questions asked in a clear and understandable application.

"Implementing third party review would allow those few individuals whose policies may be cancelled to have their case reviewed by an objective, independent board established by the state," said Mike Abbott, President and CEO of American Enterprise Group and Chair of the Operations Subcommittee. "We believe these reforms will enhance peace of mind for consumers purchasing individual health care coverage."

Third, the new proposal outlines five critical steps that states would need to follow if they seek to achieve universal participation by requiring that every citizen in the state have health care coverage. If a state takes these steps and achieves universal participation, health insurance plans could then guarantee coverage to all applicants, without regard to pre-existing medical conditions.

To achieve universal participation, states would need to develop an insurance coverage verification system; enforce the requirement to purchase and maintain coverage; establish an automatic enrollment process; provide premium subsidies for moderate- and low-income individuals and families; and secure funding for the coverage initiatives from a broad base of sources.

"Given our extensive experience, health plans can provide invaluable assistance to states as they experiment with different health care coverage options," said Charles Baker, President and CEO of Harvard Pilgrim Health Care and Co-Chairman of the Individual Market Task Force.

The private individual health insurance market currently provides coverage to 18 million people who do not have access to employer-sponsored health insurance and are not eligible for public programs. AHIP's new survey of the individual health insurance market will also be released today. The survey found that individually purchased health insurance is more affordable and accessible than may be widely known and that it offers a broad array of benefits.

To learn more about AHIP's individual market guarantee access proposal, click here: http://www.ahip.org/content/default.aspx?docid=21727.

To learn more about AHIP's previous policy proposals, visit http://www.ahipbelieves.com.

America's Health Insurance Plans - Providing Health Benefits to More Than 200 Million Americans


'/>"/>
SOURCE America's Health Insurance Plans
Copyright©2007 PR Newswire.
All rights reserved

Related medicine news :

1. Cleveland Clinic Press Releases Journal-Writing Book Write for Life: Healing Body, Mind, and Spirit Through Journal Writing by Sheppard B. Kominars, Ph.D.
2. Leading Child Abuse Center Releases Back to School Tips to Protect Children From Internet Predators
3. JHA Releases 2007 U.S. Group Disability Mid-Year Market Survey Results
4. Verdict One Releases Directory of Board Certified Attorneys for Consumers
5. Academy releases emergency preparedness tools to enable millions more people to shelter in place
6. Provectus Pharmaceuticals, Inc. releases summary results of phase 1 metastatic melanoma study
7. MITEM Releases Blue Iris eLaborate 8.6
8. Produce for Better Health Foundation Releases Statement on Study Saying Fruit & Vegetable Consumption Not Strongly Associated With Colon Cancer Risk
9. Patient Safety Authority Releases Advisory Focusing on Common Causes of Medication Errors
10. URAC Releases Issue Briefs Examining Stakeholders Views of Care Coordination Along the Healthcare Continuum
11. Cardiac Science Releases New Cardiac Rehabilitation System
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:12/5/2016)... ... December 05, 2016 , ... Sabah Shah MD, MBA has joined the Retina Group ... New York was founded by James M. Maisel, MD and has been providing tertiary medical ... always followed a legacy of surpassing expectations amongst her peers. Growing up in a ...
(Date:12/5/2016)... (PRWEB) , ... December 05, ... ... professional calibrations is an excellent way to ensure moisture measurements are consistently ... time-consuming and impractical. , Now, METTLER TOLEDO offers a solution: ...
(Date:12/5/2016)... ... 05, 2016 , ... A newly released study has found ... and accuracy of placing precordial electrodes with little cognitive effort and a high ... years, studies have shown that single electrode misplacement is one of the single ...
(Date:12/4/2016)... California (PRWEB) , ... December 03, 2016 , ... ... lower thirds, 4 transitions and many more tools allowing FCPX editors to create ... of Pixel Film Studios. , Perfect Harmony contains a beautifully designed 3D ...
(Date:12/4/2016)... Dallas, TX (PRWEB) , ... December 03, 2016 ... ... of the “Fastest growing Entrepreneurial Company in the Dallas area” Tuesday evening at ... the Omni Dallas Hotel, presented by SMU's Cox School’s Caruth Institute for Entrepreneurship. ...
Breaking Medicine News(10 mins):
(Date:12/5/2016)... 2016 Sanovas, Inc., a life science ... launch of its wholly owned subsidiary, Intubation Science, Inc., and ...   Logo - http://photos.prnewswire.com/prnh/20161202/445251LOGO   ... Sanovas, Inc. ... There are over 40 million Endotracheal ...
(Date:12/5/2016)... , Dec. 5, 2016  Recently Zymo ... methylation age predictor, known as Horvath,s Clock. Based ... a sample analysis service to academic and biopharma ... any human sample, other than sperm. The ... accurately estimate biological age versus chronological age following ...
(Date:12/5/2016)... Dec. 5, 2016  BD (Becton, Dickinson and Company) ... technology company, will demonstrate an enhanced technology platform designed ... including the company,s leading Pyxis™ and Alaris™ systems, at ... 2016 Midyear Meeting being held in ... While national data show that approximately 68 percent of ...
Breaking Medicine Technology: